citalopram hydrobromide
10 mg, 10 mg/5 mL, 20 mg, 20 mg/10 mL, 30 mg, 40 mg — Tablet
Also known as:
citalopram hydrobromide oral
CITALOPRAM HYDROBROMIDE CAPS 30MG
citalopram hydrobromide soln 10mg/5ml, 20mg/10ml; tabs 10mg, 20mg, 40mg
citalopram hydrobromide caps 30mg; soln 10mg/5ml, 20mg/10ml; tabs 10mg, 20mg, 40mg
citalopram hydrobromide tab 10 mg (base equiv), 20 mg (base equiv), 40 mg (base equiv)
CITALOPRAM HBR
CELEXA
citalopram hydrobromide tab 10 mg (base equiv), 20 mg
citalopram hydrobromide soln 10mg/5ml,
Citalopram Hydrobromide Oral Tablet
Citalopram Hydrobromide Oral Solution
citalopram hydrobromide caps 30mg; soln
Compare Prices
Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
AmeriHealth Caritas NC
10 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Bronze Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Essential + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Signature + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Silver Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
| AmeriHealth Caritas Next Gold Premier + No Referrals | Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Connect myDiabetesCare Silver
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver 4400 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Bronze 7000 HSA Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect myDiabetesCare Bronze
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Bronze 5500 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Bronze RD 6000 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver 3500 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Bronze RD 5000 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver RD 3500 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Bronze 6500 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver 3000 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver RD 5000 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Gold 1500 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver RD 2200 Indiv Med Deductible
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ | QL |
|
Connect Silver CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
|
Connect Bronze CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
|
Connect Gold RD CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
|
Connect Bronze RD CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
|
Connect Gold CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
|
Connect Silver RD CMS Standard
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ | QL |
Medicare Part D
280 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Dual (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Value Plus (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Prime (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature Care (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Enhanced (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Enhanced (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature Giveback (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Signature (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Signature (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Freedom (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Liberty (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 30 per 30 days | QL |
|
Longevity Health Plan (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | — | None |
| HealthSpring True Choice (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring TotalCare (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Select (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Savings (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| HealthSpring Preferred Plus (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 60 per 30 days | QL |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CORE 001 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 001 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 003 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 005 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE 008 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
NHC Advantage (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ 600 per 30 days | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
PruittHealth Premier (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ 600 per 30 days | QL |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ 600 per 30 days | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | ✓ 600 per 30 days | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Simple Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Simple (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Giveback Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Blue Medicare PPO Enhanced (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Blue Medicare Essential Plus (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Blue Medicare Enhanced (HMO-POS) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Blue Medicare Choice (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Blue Medicare Essential (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Experience Health Medicare Advantage (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Healthy Blue + Medicare (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health Platinum (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health smartHMO (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health Platinum Select (HMO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| Alignment Health AVA (PPO) | Tier 1 - Preferred Generic | — | — | ✓ 45 per 30 days | QL |
| HealthTeam Advantage Plan I (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Plan II (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Troy Medicare (HMO) | Tier 1 - Preferred Generic | — | — | — | None |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Assist Open (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Advantage Plan (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Community Plan (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | — | None |
|
Provider Partners North Carolina Essential Plan (HMO I-SNP)
via CITALOPRAM HBR |
Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5216-211 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Full Access H5525-034 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-049 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-050 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-070 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| HumanaChoice H5525-083 (PPO) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Choice H8145-004 (PFFS) | Tier 1 - Preferred Generic | — | — | — | None |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Senior Care (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
Wellcare Giveback Open (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
Liberty Medicare Advantage (HMO C-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Wellcare Simple (HMO-POS)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Dual (HMO D-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Value Plus (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Prime (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature Care (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Full Dual Care (HMO D-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Enhanced (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Enhanced (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Enhanced (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature Extra (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature Giveback (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Signature (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Wellcare Simple Open (PPO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
Troy Medicare (HMO)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | — | None |
|
Aetna Medicare Chronic Care (HMO C-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Aetna Medicare Chronic Care Value (HMO C-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Senior Care (HMO I-SNP)
via CITALOPRAM HBR |
Tier 2 - Generic | — | — | ✓ 600 per 30 days | QL |
|
Humana Gold Plus H6622-057 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-060 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-061 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Choice H8145-004 (PFFS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Dual Complete NC-S001 (PPO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice Giveback H5216-017 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Blue Medicare Essential Plus (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Blue Medicare Enhanced (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Blue Medicare Choice (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Blue Medicare Essential (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Experience Health Medicare Advantage (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Healthy Blue + Medicare (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
HumanaChoice H5216-211 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Full Access H5525-034 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice Giveback H5525-035 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-049 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-050 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-070 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Alignment Health Platinum (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health NC Duals (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health smartHMO (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health Platinum Select (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health Heart & Diabetes Care (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Alignment Health AVA (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
Humana Dual Select H5525-072 (PPO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HumanaChoice H5525-083 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-025 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H6622-026 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Dual Select H6622-027 (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0016 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0004 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0001 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage Access from UHC NC-23 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Dual Complete NC-S2 (PPO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-137 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-233 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Dual Select H1036-307 (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus Giveback H1036-318 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Humana Gold Plus H1036-335 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Blue Medicare PPO Enhanced (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | ✓ 600 per 30 days | QL |
|
HealthSpring True Choice (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Erickson Advantage Champion (HMO-POS C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring TotalCare (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring TotalCare Plus (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Nursing Home Plan NC-F001 (PPO I-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred Select (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred Savings (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthSpring Preferred Plus (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Complete Care NC-28 (HMO-POS C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Complete Care NC-27 (HMO-POS C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Complete Care NC-25 (HMO-POS C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Erickson Advantage Liberty (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Erickson Advantage Freedom (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Erickson Advantage Guardian (HMO-POS I-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
Erickson Advantage Signature (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-26 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-24 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Dual Complete NC-S3 (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CORE 001 NC (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED GIVEBACK 002 NC (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED GIVEBACK 012 NC (HMO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0015 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Dual Complete NC-V001 (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0012 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0011 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0009 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0008 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 001 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 003 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 005 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE 008 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
UHC Dual Complete NC-D001 (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0007 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0022 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0021 (HMO-POS)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0019 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
AARP Medicare Advantage from UHC NC-0017 (PPO)
via CITALOPRAM HBR |
Tier 3 - Preferred Brand | — | — | — | None |
|
HealthTeam Advantage Plan I (PPO)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Access (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
HealthTeam Advantage Plan II (PPO)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Liberty Open (PPO D-SNP)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Assist Open (PPO)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
HealthTeam Advantage Vitality Plan (PPO)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
Wellcare Dual Liberty (HMO-POS D-SNP)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
|
HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
via CITALOPRAM HBR |
Tier 4 - Non-Preferred | — | — | — | None |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | — | — | — | None |